Wound healing is a dynamic and complex process. According to Wound Care and the internationally accepted TIME rule, wounds can be staged according to tissue color: black stage, yellow stage, red stage, and pink stage. The nursing goals and dressing selection of different stages are significantly different.
scientific management, accelerated healing
01 Wound staging and nursing goals
Black stage (necrotic tissue stage)
Characteristics: The wound surface is covered with brown or black dry hard scab/eschar, accompanied by necrotic tissue, and no active tissue growth.
Nursing goal: Remove necrotic tissue (debridement) and prevent infection.
Basis: Wound Care points out that in the black stage, autolytic debridement or enzymatic debridement should be used to remove necrotic tissue to avoid the spread of infection.
Recommended dressing: Hydrocolloid wound dressing, Hydrogel wound dressing, Chitosan wound dressing.
Yellow stage (inflammatory exudation stage)
Characteristics: mainly slough, yellow-white necrotic tissue, increased exudate, and may be accompanied by infection.
Nursing goal: Control infection, absorb exudate, and promote granulation growth.
Literature support: Studies have shown that moist dressings can maintain a moist environment on the wound surface and accelerate the dissolution of necrotic tissue (Chinese Journal of Nursing, 2020).
Recommended dressing: Silicone foam wound dressing, Hydrocolloid wound dressing, Hydrogel wound dressing, Alginate wound dressing, Chitosan wound dressing
Red stage (granulation growth phase)
Features: The base is bright red granulation tissue, rich in blood vessels, and reduced exudate.
Nursing goal: Protect granulation tissue, promote epithelial crawling, and prevent secondary injury.
Basis: Wound Care emphasizes the need to select low-viscosity dressings at this stage to avoid damaging new tissue when removed.
Recommended dressing:Silicone foam wound dressing, Hydrocolloid wound dresisng, Hydrogel wound dressing, Alginate wound dressing, Chitosan wound dressing.
Pink stage (epithelialization phase)
Features: New epithelial cells cover the wound surface, pink, and close to healing.
Nursing goal: Protect the epithelium, maintain a moist environment, and promote complete healing.
Literature support: Studies have confirmed that closed dressings can reduce scar formation (Chinese Journal of Reparative and Reconstructive Surgery, 2019).
Recommended dressing:Hydrocolloid wound dressing, Hydrogel wound dressing, Chitosan wound dressing.
02 Guide to selection of moist functional dressings
Based on wound staging, combined with Wound Care and clinical research, the following dressing types are recommended:
03 Precautions
The frequency of dressing changes needs to be adjusted according to the amount of exudate to avoid excessive drying or soaking.
Scientific selection of moist dressings is the key to wound care. It is recommended to dynamically adjust the care plan in combination with wound staging under the guidance of professional medical staff.
04 Literature source:
Wound Care (People's Medical Publishing House): Systematic explanation of the TIME rule and staged care standards.
Zhang Li et al. Application of moist healing theory in chronic wound care [J]. Chinese Journal of Nursing, 2020;
Wang Qiang. Mechanism of action of new dressings in wound repair [J]. Chinese Journal of Reparative and Reconstructive Surgery, 2019.
